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Hospital laboratory experience with SARS-CoV-2 (COVID-19) molecular assay sample pooling method in New York City
  1. Iskender Sinan Genco,
  2. Kevin Williams,
  3. Jeffrey Pacheco,
  4. Oana Vele,
  5. Scott Duong,
  6. Dennise Otero Espinal
  1. Department of Pathology and Laboratory Medicine, Lenox Hill Hospital, New York City, New York, USA
  1. Correspondence to Dr Iskender Sinan Genco, Pathology and Laboratory Medicine, Lenox Hill Hospital, New York, NY 10075, USA; iskendergenco{at}; Dr Dennise Otero Espinal, Pathology and Laboratory Medicine, Lenox Hill Hospital, New York, NY 10075, USA; doteroespina{at}

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The ongoing SARS-CoV-2 (COVID-19) pandemic has been a huge challenge for healthcare systems worldwide. Laboratories have been confronted with rapidly increasing testing demands that exceed testing capacity. Regions with a low SARS-CoV-2 molecular assay positivity rate are looking for ways to increase testing capacity and prevent a second wave while returning to ‘normal’ life. One aspect of this process is to reopen non-COVID-19 related medical services that were shut down due to SARS-CoV-2 transmission risk.

Sample pooling method has been used for mass testing of several infectious diseases for decades and is currently proposed as a new strategy to increase COVID-19 testing capacity in low-risk regions.1–5 New York State Department of Health (NYSDOH) requires patients to be tested for COVID-19 using a molecular assay for detection of SARS-CoV-2 RNA before medical procedures. While the number of medical procedures were rapidly increasing at our hospital, the supply of SARS-CoV-2 molecular assay reagents has been insufficient and inconsistent. To meet the need of testing before medical procedures in a timely manner and prevent possible delays in patient care, Lenox Hill Hospital laboratory implemented the sample pooling method for patient testing. We, herein, report our 6-week experience with pool testing for COVID-19.

In the beginning of July 2020, we validated the pooling testing method for COVID-19 using the Cepheid Xpert Xpress SARS-2 CoV-2 (EUA) cartridges on GeneXpert System (Cepheid, Sunnyvale, California, USA) by using the recent guidelines published by the Food and Drug Administration and NYSDOH.6 7 The SARS-CoV-2 positivity rate at Lenox Hill Hospital of Northwell Health was <3% over the last month with the majority of the days being 0%–1%. Briefly, a sample pool was created by combining 200 µL of Universal Transport Medium from each …

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  • Handling editor Tahir S Pillay.

  • Contributors ISG (concept, design, analysis and manuscript writing), KW (concept, design and testing); JP (concept, design, testing and analysis); and OV, SD and DOE (concept, design, analysis, editing and supervision).

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.